global health exam 3

case

an individual with a particular disease

control

reducing the incidence and prevalence of a disease to an “acceptable” level, still requires public health intervention efforts

covid

eradication

reducing the incidence of a disease in a specific area to zero, no longer requiring public health intervention efforts

elimination

complete and permannent wolrdwide reduction to zero cases of the disease through deliberate efforts

emerging infectious disease

a newly discovered disease, may be new in origin or recently discovered previously existing disease

reemerging infectious disease

an exitsing diease that has increased in incidence, spread to a new place or has tken on new forms

TB

parasite

an organism that lives in or on another organism and takes its nourishment from that organism

food borne

salomnella

e coli

waterborne

cholera

rotavirus

contact/sexual or blood borne

hepatitus

HIV

vector borne/zoonotic

malaria, rabies

aerosol/inhalation

TB

influenza

meningitis

worlds three deadliest infections

TB, malaria, HIV/AIDS

textbook reading: the global aids response

what was the golden age of global health?

global health funding increased significantly from 1998 to 2007

the US government increased international AIDS funding more than tenfold between 2000-2006

PEPFAR, global fund, gates foundation

PEPFAR

theU.S. President's Emergency Plan for AIDS Relief- globalhealth initiative launched in 2003

George W. Bush

funding for global AIDS prevention and treatment

$15 billion over 5 yrs

supported tx for 3 million ppl by 2009

global fund

estblaished in 2002 to fight aids, TB, malaria

independent international organization

gates foundation

Bill and melinda gates

a large private charitable foundation that fundsand manages global health, poverty reduction, and education initiatives

distrubutes vaccine

research

HIV vs. AIDS

(human immunodeficiency virus)

(acquired immunodeficiency syndrome)

HIV is a virus that attacks the immune system

AIDS is the advanced stage of HIV infection

ART

antiretroviral therapy

medication that supresses HIV and prevents disease progression

the current, preferred medical term for the daily pills or monthly/bimonthly injections

reduces the viral load to undetectable levels, meaning the virus cannot be sexually transmitted and allows patients to live a normal lifespan

HAART

highly active antiretroviral therapy

combination of three drugs

considered obsolete today because all standard HIV regimens are now combination therapies. 

how was his/aids viewed in 1980s/early 1990s

HIV/AIDS was largely considered a death sentence because effective treatments were unavailable.

1996

HAART showed that combining three antiretroviral drugs could supress HIV and restore immune function and live longer lives

reduced deaths

became a manageable chronic condition

intial problem w HAART

costly

companies charged 10-15k per patient annually

wasnt accessible in developing countries

policymakers agrued that poor countries lacked the healthcare professionals and infastructure. and that the ppl wouldnt be able to follow the complicated medication schedules. “money should be spent on prevention instead of tx”

andrew natsios- head of USAID said some of these things

south african medicines act (1997)

allowed possibillity of importing less expensive meds

produced generic versions of meds could be produced

pharma comapnies opposed this bc it threatened them, 39 companies sued south africa in an attempt to overturn the law

what happened w the lawsuit

US and south african activists joined tg

ACT UP, health GAP, south africa’s tx action campaign organzied protests

pharma companies withdrew lawsuit in 2001

The Doha Declaration (2001) affirmed that intellectual property protections should not prevent countries from protecting public health.

• allowed greater flexibility to use generic medication, same active ingredients but affordable

bono and jesse helms

Bono,the lead singer of U2, has made a major global health impact

cofounded ONE and RED campaigns that supported PEPFAR, partnered with iconic brands to raise money for global fund, DATA (debt, aids, trade, Africa)

Conservative Republican senator who initially opposed foreign aid but eventually became a supporter of AIDS relief.

made a ban that stopped the CDC from using federal funds for any AIDS education or prevention materials that "promote, encourage, and condone homosexual sexual activities or use of drugs”

results of global aids response

By the end of 2011, 6.6 million people worldwide were receiving ART, reducing transmission BY 96%

millions of deaths were prevented

drug prices decreased

more ppl in developing countries accessed lifesaving meds

funding for malaria also increased

challenges that remained after golden age

global health equity had not been achieved

access to tx still devastated populations

The 2008 global economic downturn caused some countries to reduce or fall short of foreign aid commitments.

vertical health programs

Focus on one specific disease.

Ex: HIV/AIDS treatment programs.

vertical AIDS programs can also strengthen horizontal systems

ex: HIV programs require trained health professionals, clinics, laboratories, and community health workers. These resources can also help treat tuberculosis, pneumonia, etc

horizontal health programs

Focus on overall health care and strengthening health systems

Ex: Primary care, maternal health, nutrition, and general medical services.

S UN D A R

Simplify the message

Unpack the treatment

Deliver it where people are

Affortable and available human resources

Reallocation of specialists to train and supervise

-taking community members and training them to be on the first line of treatment